Abstract
This month’s edition of ANZJP features debate and studies involving e-mental health, an area in which Australia appears to lead the world. The Editorial by Jorm et al. (2012) sums up the issues as do Viewpoints by prominent researchers in the field (Christensen and Petrie, 2012a; Griffiths, 2012; Titov et al., 2012), where Griffiths presents a possible vision for the future: a ‘virtual mental health community’. Proudfoot (2012) focuses particularly on the possible use of mobile phones and other such devices (mHealth) and reviews the possibility that mobile technology could, in the future, be widely used for monitoring various aspects of mental health, performing immediate interventions and perhaps allowing integration and access of electronic health records.
Such advances will not be possible, however, without rigorous ongoing research, and some of the potential pitfalls are noted by other authors. For example, Christensen and Petrie (2012b) note the considerable number of web-based programmes for a range of mood and anxiety disorders, which have not been evaluated in any research trial, and Carter et al. (2012) present data that illustrate the difficulties of recruiting for a trial of e-cognitive behaviour therapy (CBT) in a secondary care service, with only 8% of referrals being recruited.
Of course there are also negative effects of internet use and this is examined by Park et al. (2012) in Korean adolescents. Nearly 10% of adolescents studied met criteria for problematic internet use and this predicted depressive symptoms and suicidal ideation. This is followed by a Commentary by Tam (2012), which explores the problem more generally and makes the suggestion that an inventory of internet use should be part of the clinical assessment of young people from a non-English speaking background. With many studies finding a rate of around 10% for problematic internet use in adolescents, perhaps it should always be part of standard clinical assessment in this age group.
Those of you reading this in tangible form, namely paper, and who have difficulty understanding the workings of even the simplest of phones, will probably imagine that e-mental health initiatives are only likely to be helpful for the ‘younger generation’. However, in a trial of Internet-delivered CBT for depression in adults aged 60–80 years (Dear et al., 2012), 20 patients took part and 16 completed an 8-week programme, including five ‘on-line’ lessons with good outcomes.
Those of you who are unconvinced will be pleased to see at least some ‘non-e’ content in this month’s Journal. The review of pharmacotherapy for obsessive compulsive disorder (OCD) by Fineberg et al. (2012) is rigorous and extensive and a useful reference for all clinicians treating OCD. The Letters section (should we rename this ‘e-correspondence’?) continues debates on long-running controversies, with further opinion regarding the treatment of youth ‘at risk’ of psychosis (Rosenman, 2012) and more on the issue of conflicts of interest (Ryan and Harris, 2012). We hope that these debates will continue on these pages/computer screens and that readers will correspond regarding the debate in this edition on e-mental health, its development, importance and future significance.